15100169I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 10524 METEOR PL I CONTRACTOR: SCL CONSTRUCTION CO. I PERMIT NO: 15100169
OWNER'S NAME: BROOKS ERIC G TRUSTEE 11664 SAMEDRA ST I DATE ISSUED: 10/21/2015
OWNER'S PHONE: 4085170974
b/ LICENSED CONTRACTOR'S DECLARATION
License Class�r j ^ Lic. #
Contractor J �L (�y►S'�I�rrnC Y. Date /O
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
1. I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
ormance of the work for which this permit is issued.
d',J,haje and will maintain Worker's Compensation Insurance, as provided for by
� jon 3700 of the Labor Code, for the performance of the work for which this
ermit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply with
all non -point source regulations per the Cupertino Municipal Code, Section 9.18.
Signature — ro — 20 — I
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
1 1 have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
2. I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
3. I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I
must forthwith comply with such provisions or this permit shall be deemed
revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply with
all non -point source regulations per the Cupertino Municipal Code, Section 9.18.
Signature,
Date
SUNNYVALE, CA 94087 I PHONE NO: (408) 497-1556
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
REPLACE (4) WINDOWS IN THE REAR OF 1 ST FLOOR
Sq. Ft Floor Area: I Valuation: $3000
APN Number: 32644013.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS
FROM LAST CALLED INSPECTION.
Issued by: i ,/1 1� Date: o z` I
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent:
Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (See. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CONSTRUCTION PERMIT APPLICATION
V6 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CCUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildiinng(d),cugerbno.org 15/00 ( (o
I IimwcCIN.CTRTICTTO-i F7AT)T-)TTTON f7' AT.TFRATTCIN/TT FI RFVT.gTnv/T)T=T�T=RRRT) nRT(-TWAT.PpizmTT:
PROTECT ADDRESS ���
APN R / — 0 `
L4 Lf
` J
OWNER NAME ^ p PHO t� �] E -Mk
C'V
STREET ADDRESS CITY, STATE, ZIP FAX
1
CONTACT NAME.PPHONE'`
_ /� r
/
E-MAIL
STREET ADDRESS T'ITY,
STATE, ZIP
FAX
921110\�WER ❑. OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUTABER _ _ f .�
LICENSE TYPE 1�
BUS. LIC N
COMPANY NAifE
E-MAIL
FAX
STREET ADDRESS I�// �4h _/ w L
ALT
CITY, STATE, ZIP
r
PHONE
unI j,�{�• L O
T
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC 4
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE; ZIP
PHONE
DESCRIPTION OF WORK
wit it t r����z
V
EXISTING L)SE PROPOSED USE CONSTR TYPE I STORIES
I
USE
TYPE
I OCC.
SQ.FT.
VALUATION (S)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: Ll DETACH
❑ ATTACH
R D -WELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEING ADDED? ❑NO
ADDITION? ❑NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
TZECEIVETO
VALUATION:
PLAN'NTNG ADPL R ❑ NO PLANN NG APPROVAL LETTER
EICHLER HOME? ❑ NO19
_
C2
By my signature below, I certify to each of the following: I am the property owner or authorized agent act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of �N7ork and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent:'�—� Date: l
S11—
SUPPLEMENTAL D\I ORALITION REQUIRED
New SFD or Multifamily dNvellings: Apply for demolition permit for
'fl O«RTH�COUI�TEI2F'c�BTJIIDLNGPL4NREVIEW'
i
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.5�'
s I:AIQ%L�CzPLe�NTREIEW ax.
eacr�}s��
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
form if Hazardous Materials being
❑ T. ARD
i�
A
any are used as part of this project.
rY 14RGTs�s�a
T���LRE�EZ? :: *4la
_ Copy of Planning Approval Letter or Meeting with Planning prior to�
r�I
submittal of Building Permit application.
=,C� .SIA OR ��� a
e TtAR $ERERDIaA
BIdgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
IVI FEE ESTIMATOR - BUILDING DIVISION
10,
ADDRESS: 10524 METEOR PL
DATE: 10/21/2015
REVIEWED BY: pHUONG
alech_ Perwil Fc,
APN: 326-44-013
BP#:
*VALUATION: 1$3,000
xPERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Repair
PRIMARY SFD or Du lex
USE: p
Plun " ' _. Fee
PENTAMATION 1GENRES
PERMIT TYPE:
WORK
REPLACE 4 WINDOWS IN THE REAR OF 1ST FLOOR
SCOPE
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary sewer District, Scnoot
District eta These h, are based on the j7relimina information available and are only an estimate Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff' 711,'13)
If,ch. _Plan CheckT-1
Plumb, flan Check
E_lec. Plan Check
alech_ Perwil Fc,
Plumb. Permit Fe,
Elec. PermitFee•
Oiher ,Vech. Insp.
Other Plumb IrFap. Li
Uther Elec. Insp. Li
V1ech, Insp. Fee:
Plun " ' _. Fee
Jec. Insp. Fee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary sewer District, Scnoot
District eta These h, are based on the j7relimina information available and are only an estimate Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff' 711,'13)
FEE
QTY/FEET
MISC ITEMS
Plan Check Fee:
$0.00
®#
$431.00
Window / Sliding Glass Door
1 WINREP Replacement
Suppl. PC Fee: 0 Reg. o OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. FeeQ Reg. ®OT
0 0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax:
<lministrative 1 'ee:
O
G
Work Without Permit? Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
O
/
rt"Uk'{'/ 1)r�'PtPlc'ultilTtfzq %'';'s'.
Strong Motion Fee: 1BSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$1.50
$431.00
TOTAL FEE:
$432.50
Revised: 10/01/2015
sco , off- wdr<<: R�P- J9 (6 CR- (C4) wi IAO(060S e raq,- 04 1
u - �k CJD ✓ . 32 max
2-o13 C?C
11 CUPS TINO
Building Department four- first floor windows
OCT 1912015
REVIEWED FOR CODE COMPLIANCE family -nook -kitchen -dinning
Reviewed By:
>111110
a
O
U
Uj
U
uz-
LL
O
Hoop /l' --
entrance portch
three car garage
10524 METEOR PL, CUPERTINO, CA 95014
OWNER - LARISSA WU
TEL- 408-517-0974
RECEIVED
BY
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION - CUPERTINO
APPROVED
This set of plans and specifications MUST be kept at the
jcb site during construction. It is unlawful to make any
changes or alterations on same, or to deviate
"rerefrom, without approval from the Building Official.
_^e Stamping of this pian and specifications SHALL NOT
e held to permit or to be an approval of the violation
It any prov y City Ordinance or State Law.
BY
DATE D
PERMIT # 6 D 6
rear yard
6x4
12x8 patio door window
6x4
5x4
windo
window
w
11 CUPS TINO
Building Department four- first floor windows
OCT 1912015
REVIEWED FOR CODE COMPLIANCE family -nook -kitchen -dinning
Reviewed By:
>111110
a
O
U
Uj
U
uz-
LL
O
Hoop /l' --
entrance portch
three car garage
10524 METEOR PL, CUPERTINO, CA 95014
OWNER - LARISSA WU
TEL- 408-517-0974
RECEIVED
BY
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION - CUPERTINO
APPROVED
This set of plans and specifications MUST be kept at the
jcb site during construction. It is unlawful to make any
changes or alterations on same, or to deviate
"rerefrom, without approval from the Building Official.
_^e Stamping of this pian and specifications SHALL NOT
e held to permit or to be an approval of the violation
It any prov y City Ordinance or State Law.
BY
DATE D
PERMIT # 6 D 6